title: Developing and sustaining leadership in public health nursing: findings from one British Columbia health authority.
abstract: OBJECTIVE
  To develop clinical leadership among front-line public health nurses (PHNs).
  
  
  METHODS
  This paper describes a quality improvement process to develop clinical leadership among front-line PHNs. Three activities were undertaken by a working group consisting mainly of front-line staff: engaging PHNs in an online change-readiness questionnaire, administering a survey to clients who had ever used public health services delivered by one Vancouver Community Infant, Child and Youth (ICY) program team and conducting three group interviews with public health providers. The group interviews asked about PHN practice. They were analyzed using thematic content analysis.
  
  
  RESULTS
  This quality improvement project suggests that PHNs (n=70) strongly believed in opportunities for system improvement. Client surveys (n=429) and community partner surveys (n=79) revealed the importance of the PHN role. Group interview data yielded three themes: PHNs were the "hub" of community care; PHNs lacked a common language to describe their work; PHNs envisioned their future practice encompassing their full scope of competencies. PHNs developed the "ICY Public Health Nursing Model," which articulates 14 public health interventions and identifies the scope of their work.
  
  
  CONCLUSIONS
  Developing and sustaining clinical leadership in front-line PHNs was accomplished through these various quality assurance activities.
authors.affiliation: 0-5 Program, Infant, Child and Youth, Vancouver Coastal Health, Vancouver, BC, Canada.
authors.forename: Leslie
authors.initials: L
authors.lastname: Mills
authors.forename: Sabrina T
authors.initials: ST
authors.lastname: Wong
authors.forename: Radhika
authors.initials: R
authors.lastname: Bhagat
authors.forename: Donna
authors.initials: D
authors.lastname: Quail
authors.forename: Kathy
authors.initials: K
authors.lastname: Triolet
authors.forename: Tannis
authors.initials: T
authors.lastname: Weber
mesh_terms: D000293:Adolescent; D001291:Attitude of Health Personnel; D001955:British Columbia; D002648:Child; D003152:Community Health Nursing / Q000458:organization & administration; D003695:Delivery of Health Care / Q000458:organization & administration; D005260:Female; D017144:Focus Groups; D006801:Humans; D007223:Infant; D020407:Internet; D007857:Leadership; D008297:Male; D009313:National Health Programs; D009740:Nursing Staff / Q000458:organization & administration; D009746:Nursing, Team / Q000458:organization & administration; D010371:Pediatric Nursing / Q000458:organization & administration; D011637:Public Health Nursing / Q000458:organization & administration*; D058996:Quality Improvement / Q000458:organization & administration*; D011795:Surveys and Questionnaires